SERVICES Online Virtual program Consultalion From ($100) Please enable JavaScript in your browser to complete this form.Name *FirstLastOccupationEmail *Cell PhoneHome PhoneHow long have been dealing with hair loss?1 month2 month3 monthWhat are the products you are using at home?oilshampooconditionertreatmentsIs your hair chemically treated?yesnoRelaxercolorpremIs the hair?breakingSheddingWhere is your hair loss located?crowedgeWhen did you last use chemical?WeekmonthHave you saught professional help (Doctor) for your hair loss?yesnoIf yes when?What was your diagnosis?What do they recommend?What were your resultsWhich others soultion have you try?How frequently do you shampoo your hair?WebsiteSubmit
